by Howard M. Turney
Our children misbehave, friendships become conflicted, family members act up during holiday celebrations. These are all experiences that may manifest in our lives. Because of our affection for the person behind these incidents, we may take for granted behaviors that could be defined as pathological. We do not see these behaviors for what they may be. It is most difficult to recognize and deal with mental illness within our family and social group. Our spouse is depressed, or our child was expelled from school. A mother-in-law drinks too much. Finding a gentle confrontation for those we care about can be challenging. Getting the necessary help can be an opportunity for a more satisfying life.
Perhaps there is a reluctance to face what might be a treatable mental health issue. There is a tendency in all of us to normalize and overlook crippling anxiety or disabling depression. Addictions insidiously creep into our lives and somehow permeate family interactions. Psychotic disorders can fracture a family beyond repair. Crippling anxiety can interfere with activities of daily living. Understanding the complexity of unusual or self-destructive behavior as an illness (like any physical illness) is essential to successful treatment.
Daily, mental health practitioners are faced with a barrage of calls from loved ones and friends for help for someone important to them. Significant others seek help for someone they love. The complication in this is that symptoms of mental illness are seen in behavior. How people act and treat others may be symptomatic of an underlying mental health issue. A pattern of hurt feelings may signal more difficulties than meet the eye. For those who do not obtain help, other less amicable solutions may develop. Divorce, custody battles, family dissolution, or even incarceration may occur. Many of these are preventable.
Being attuned to unusual behaviors can be the first tip toward recognizing disturbances in mental health. A person with a long history of fractured relationships may provide insight into a disturbed personality structure. Withdrawal and isolation may be indicative of depression. The inability to maintain employment may signal underlying anxiety. The constellation of symptoms of mental health is well-defined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
Family members may not want to believe that one of their own could be suffering from a full-blown mental illness. Because of the stigma associated with mental health, we tend to normalize or tolerate behavior and emotions that inhibit living life to the fullest. Relationships are strained, our personal productivity is limited or we lack the ability to sustain affection for others. Recognizing the signs of mental illness can provide a path into seeking the necessary treatment to alleviate the symptoms.
Along the continuum of mental illness is a range of diagnoses from adjustment disorders to schizophrenia, with many disorders in between. The features of these diagnoses range from a situational depressed mood to a break from reality. Some typical signs of mental illness include a sudden change in behavior, isolation, suicidal thinking, excessive anger, fatigue, reduction in self-care, inappropriate expressions of emotions, over reactiveness, risky behaviors or inability to cope. Children may act out in ways that are disruptive at home or school or may exhibit uncontrollable behaviors. They may become truant or disrespectful. The caution with children and adolescents is not to mistake developmental milestones with mental illness.
The onset of mental illness can challenge family members. Often parents blame themselves for a child’s diagnosis or believe that their child’s illness is the result of poor parenting. A clinical diagnosis can alter hopes and dreams for their children. The configuration of the family may shift as more attention is focused on the identified patient. It is important for the family to educate themselves about the illness and for the family to participate in treatment.
Families may readjust roles and responsibilities to ensure safe and appropriate treatment. No doubt this can create chaotic situations for everyone involved. In most cases, help is available. Taking the first step is likely the most difficult. Beyond that are well-trained professionals to provide the necessary help to allay your fears, provide support and intervene with evidence-based treatments to maintain a normal lifestyle.
Adults with mental illness need the same compassion and support as children. Too often mental health challenges create an economic hardship on families. Addictions, mood disorders, and personality disorders can wreak havoc on spouses, children, and extended family. Approaching the family member with understanding and hope can create an atmosphere of care that encourages patients to comply with treatment and use new coping skills to manage the illness.
Often families are more fearful of illnesses involving the mind than they are the body. People will willingly talk about their bad cold or stomach issues but will not talk about their tendency to want to stay in bed, not bathe, and avoid interactions with others. All those can be symptoms of depression, and few people are going to share easily about a possible mental health diagnosis. The stigma of mental illness is fading in our society, but one still exists. Families who have a history of mental illness are especially sensitive to the topic and often keep “family secrets” about a grandmother who had a ‘“nervous breakdown” and was put in a hospital. Or that a crazy uncle always drank too much and had to be bailed out of jail numerous times. It’s as if there are tainted genes and any mention of a current issue would bring down the current state of health of the family. So often families are the worst to ignore symptomatic behavior lest they stir up the skeletons in the closet.
Treatment of mental illness has improved. Psychiatric medication has become so effective in the last 50 years that most diagnoses are treatable with a combination of medication and therapy.
In today’s world, friends are often more apt to confront a friend or loved one who has seemed “different” because they don’t have a fear of having the same malady. And, there has not been a decade’s old collusion of family members who ignore what might cause an emotional revolution in the family. The world is changing. Society is gradually emerging into a world where physical and mental illnesses are all part of a continuum of conditions that deserve equal attention.